Published in Pediatric Allergy and Immunology. Here is a link to the article.
Regenstrief Institute author: Arthur H. Owora, PhD, MPH
The content below has been provided by article authors Dr. Owora and Anuja Bandyopadhyay, M.D.
Impact of asthma on sleep and associated risks
About 30 to 40 percent of children with asthma experience sleep difficulties due to symptoms like coughing and wheezing. Poor sleep increases the risk of severe asthma exacerbations (attacks) that often necessitate a hospitalization or emergency department admission causing a significant burden to the patient/caregivers and healthcare system. However, there is a paucity of research on practical ways of identifying children with asthma and sleep problems at increased risk of such severe asthma attacks who could benefit from targeted preventive intervention.
Key findings
In the study, researchers found that in addition to having a history of severe asthma attacks, children with asthma, particularly boys, who had fragmented sleep, were at greater risk for severe asthma attacks. Conversely, a history of sleep disturbance treatment (medications) was associated with lower risk of future severe asthma attacks.
A prognostic model
By incorporating easily accessible medical health record data and sleep study data, the researchers created a prognostic model that had higher accuracy for early identification of children at risk of severe asthma attacks than reliance on history of severe asthma attacks alone (approximately a proxy of current clinical practice).
Considerations for providers
Among children with asthma and sleep related problems, providers can explore referral of such patients for sleep studies to aid efforts towards early identification of at-risk children who might benefit from preventive sleep-related interventions to reduce risk of future asthma attacks.
Future direction
Going forward, the researchers plan to examine the prognostic utility of combining electronic health record data, sleep parameters and sleep microstructure data to further improve the clinical accuracy and utility of our prognostic algorithms for early identification of children at risk of severe asthma attacks. The team will also evaluate the feasibility and preliminary efficacy of various sleep-related medications identified in the study as a preventive strategy to reduce the risk of severe asthma attacks among at-risk patients.
This study was in part supported by National Institutes of Health, USA grants K01HL166436 (AHO) and R03HS029088 (AHO).
Authors
Anuja Bandyopadhyay1, Bowen Jiang1, Yash Shah1, Arthur H Owora1,2
Affiliations
1Division of Pediatric Pulmonology, Allergy/Immunology and Sleep Medicine, Department of Pediatrics, Indiana University School of Medicine, Indianapolis, Indiana, USA.
2Center for Biomedical Informatics, Regenstrief Institute, Indianapolis, Indiana, USA.
